Palliative care at home to get further funds if it saves money

Burke, Katherine

doi:10.1136/bmj.328.7439.544-b

Cited by 14 publications

(8 citation statements)

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“…The UK health secretary recently voiced a commitment to ensuring that palliative care is available to all who want it and the National Health Service has launched a pilot programme to test various at-home models for terminally ill people (Burke, 2004). It is important that such initiatives take into account the changing living arrangements of older people, changes which also have implications for the quality of life of cancer sufferers.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the support of older people with cancer including support to die at home if they wish for those with terminal conditions, is becoming an increasingly important issue for health providers and policy makers. It has recently been suggested, for example, that if more cancer patients were enabled to die at home, the UK National Health Service could make savings of d100 m every year (Burke, 2004). However, information on relevant parameters, such as with whom people with cancer live, is very limited.…”

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confidence: 99%

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Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

et al. 2004

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The main objectives of the study were to (1) see whether the household circumstances of people aged 50 years and over with cancer, and trends in these, differ from those of the rest of the population and (2) whether living arrangements and presence and health status of a primary coresident are associated with place of death among older people dying of cancer and those dying from other causes. The design included prospective record linkage study of people aged 50 years and over included in a 1% sample of the population of England and Wales (the Office for National Statistics Longitudinal Study). The main outcome measures comprised family and household type, and death at home. The household circumstances of older people with cancer were very similar to those of the rest of the population of the same age and both showed a large increase in living alone, and decrease in living with relatives, between 1981 and 1991. The primary coresident of cancer sufferers who did not live alone was in most cases a spouse, with much smaller proportions living with a child, sibling or other person. In all, 30% of spouse, and 23% of other, primary coresidents had a limiting long-term illness. Compared with people who lived alone in 1991, odds of a home death among those dying of cancer between 1991 and 1995 were highest for those who lived with a spouse who had no limiting long-term illness (odds ratio (OR) 2.52, 95% confidence interval (CI) 2.15 -2.97) and raised for those living with a spouse with a long-term illness (OR 2.14, CI 1.79 -2.56) and those living with someone else who was free of long-term illness (OR 2.13, CI 1.69 -2.68). Higher socioeconomic status, both individual and area, was positively associated with increased chance of a home death, while older age reduced the chance of dying at home. The changing living arrangements of older people have important implications for planning and provision of care and treatment for cancer sufferers.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

et al. 2004

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“…However, it is the responsibility of those managing a team of carers to ensure that workload is not consistently so great that the team is exposed to sustained unsafe levels of stress 34 40. There is also a duty to ensure appropriate training for team members, as those who feel inadequately prepared to provide palliative care are more likely to find this experience difficult 6 19 41…”

Section: Discharge Planningmentioning

confidence: 99%

“Please, I want to go home”: ethical issues raised when considering choice of place of care in palliative care

Wheatley¹,

Baker

2007

Postgraduate Medical Journal

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Many palliative care patients would prefer to receive care, and to die, at home. Despite this many die in institutions. In response to this, politicians and charities have adopted policies aimed at increasing the opportunities for care and death at home. The need to discuss plans for discharge with most inpatients reinforces expectations of a choice of place of care. However, many palliative patients do not have a choice of care at home. This article will explore the circumstances in which patients are unable to choose home care and consider changes in clinical practice that can help to maximise choice. We shall argue that there is a distinction between the preferences of patients and the choices actually available to them. In attempting to make this distinction we advocate consideration of the balance between the ethical principles relevant to each case.

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“…Palliative care enables people with life limiting illness to plan and make choices about their end‐of‐life care and place of death . However, in‐hospital death typically occurs contrary to the dying person’s wishes and is associated with higher healthcare expenditures . Four in five Australians desire to die out of hospital, whereas it only occurs for half of decedents .…”

Section: Introductionmentioning

confidence: 99%

Variation in out‐of‐hospital death among palliative care inpatients across public hospitals in New South Wales, Australia

Assareh

Stubbs

Trinh

et al. 2019

Internal Medicine Journal

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Palliative care at home to get further funds if it saves money

Cited by 14 publications

References 0 publications

Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

Living arrangements and place of death of older people with cancer in England and Wales: a record linkage study

“Please, I want to go home”: ethical issues raised when considering choice of place of care in palliative care

Variation in out‐of‐hospital death among palliative care inpatients across public hospitals in New South Wales, Australia

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